What are anti-snoring mouthpieces and how do they work?

Mandibular advancement splints, mandibular repositioning devices, protrusion splints and mandibular advancement devices (MADs for short) are all the same type of snoring remedy. These are anti-snoring mouthpieces that fit in your mouth, covering your teeth like a gumshield.

Snoring comes as a result of a narrowed airway. This can be caused by over-relaxed soft tissue or the base of your tongue falling back to obstruct your breathing passageways.

Mouthpieces help to tighten the tissues in your airway that become slack during sleep. It also brings the base of your tongue away from the back of your throat, clearing it from obstruction.

A note on tongue retainers

Whilst technically an “anti-snoring mouthpiece”, tongue retaining devices (TRDs) work differently, and are not the focus of this article. These use a suction cup to pull the tongue away from the back of the throat and can still be extremely effective for tongue-based snorers [1].

Who can they help?

Some research has shown that two thirds of snorers can benefit from an anti-snoring mouthpiece. Studies also indicate that mouthpieces can be a better treatment than CPAP for mild to moderate sleep apnea sufferers [2].

At SnoreLab, we recommend mouthpieces for a number of different snorers:

Epilepsy sufferers. Mouthpieces can break into small parts due to the strong biting down that can accompany severe seizures.

Custom-made mouthpieces

Custom-made mouthpieces are bespoke devices made in specialist dental labs. Because these mouthpieces are made to fit only you, they often provide more comfort than generic mouthpieces bought online.

Discomfort is the main barrier to success when it comes to using anti-snoring mouthpieces. For this reason, custom-made mouthpieces show greater success in scientific trials simply because people are more likely to stick with them [5].

There are generally two ways to obtain a custom-made mouthpiece:

Medical referral. After seeing a specialist about your sleep breathing problems, you may be recommended a custom mouthpiece. You are likely to undergo an assessment with a dental specialist who will assess your suitability for a mouthpiece and who will take multiple measurements and impressions of your teeth.

Online services. Some companies offer a service to get a custom-made mouthpiece via the internet. After requesting, you are sent an impression kit in the post. Here, you create the indentations for your teeth and jaw alignment, send it off, and then receive the custom-made mouthpiece a few weeks later.

Due to the extra time, effort and materials invested in creating a custom-made mouthpiece, these are usually more expensive than the generic alternatives.

Generic mouthpieces – what to look for

Less expensive generic mouthpieces bought online needn’t be inferior. There are many mouthpieces available to buy online, some better quality than others.

Look out for the following key features to get a good quality generic mouthpiece that can be just as effective as the more expensive custom-made alternatives …

Custom-moldable

Custom-moldable mouthpieces use the same principles as the bespoke devices, where the mouthpiece is shaped to fit the impression of your teeth.

These devices employ a boil and bite method of molding to the shape of your teeth, whereby the mouthpiece is soaked in hot water to soften the moldable padding. After biting into the padding, holding for a period and allowing the device to cool, the mouthpiece contains an impression of your teeth, improving fit and comfort.

Adjustable

It is important to be able to adjust your mouthpiece to reduce the chance of jaw pain.

Holding your lower jaw in a protruded position is not a natural state, therefore takes some getting used to. If you advance your jaw too far too soon, you can sometimes get temporomandibular joint disorder, a condition that causes pain in your jaw joints.

Starting with the lowest protrusion setting is a great way of easing yourself into mandibular advancement. There are different mechanisms available: some squeeze, some wind and others require plastic spacers. When buying an adjustable mouthpiece, make sure the adjustment is secure, precise and easy to perform.

Allows some jaw movement

Mouthpieces are usually built from either one piece of material (monobloc) or two pieces attached to each other (bibloc).

Whilst a bibloc mouthpiece still holds your jaw advanced forward, it usually allows more lateral movement once in your mouth, reducing the chance of jaw aches.

Breathing vents

Breathing vents allow you to breathe through your mouth whilst wearing the mouthpiece.

You may be able to breathe well through your nose before you go to sleep, but this can change throughout the night. It is therefore important that your mouthpiece allows for some mouth breathing so you can still comfortably wear it.

Some mouthpieces are hinged, allowing you to open your mouth a little. Others contain a breathing hole in the front of the device.

If your nose is severely blocked, a mouthpiece might not be suitable.

Quality materials

Mouthpieces that use high-quality, medical-grade materials will last longer and are safer to use.

Also make sure that your mouthpiece is BPA-free and latex free. Better quality materials feel more comfortable in your mouth, are easier to clean and are less likely to rub uncomfortably on your gums.

Also check for FDA approval, a sign that the mouthpiece meets medical device regulations.

Slim design and sizing options

Slimmer, less bulky mouthpieces are easier to wear and more comfortable.

Intelligently designed mouthpieces can have adjustment mechanisms and moldable materials but still be low-profile and easy to wear in your mouth. This allows you to sleep more naturally and get used to the mouthpiece sooner.

Also check to see if the mouthpiece comes in different sizes. Even moldable, adjustable mouthpieces can be sized differently to provide an optimal fit for people’s varying face shapes and jaw profiles.

Lifespan and warranties

Higher quality, slightly more expensive mouthpieces are likely to last longer.

Make sure that buying cheap mouthpieces is not a false economy, as you may have to replace these more often. Generally, a good mouthpiece should last you more than 9 months.

Check if the provider offers a warranty for free replacement if the mouthpiece becomes unusable sooner than it should.

Bear in mind that if you grind your teeth in your sleep, your mouthpiece might wear out faster.

Money-back guarantees

Mandibular advancement can be a great way to reduce snoring, but it doesn’t work for everyone. Therefore, it is important to be able to change your mind.

Lots of mouthpiece manufacturers offer a money-back guarantee if after a certain period you feel that the mouthpiece isn’t right for you. This is a great way to trial the device risk-free, meaning you have nothing to lose but stand to gain much quieter nights.

The usual trial period is 30-nights but some providers offer 60-night money-back guarantees.